Public Reporting Information

Name & Location

Ochsner Accountable Care Network, LLC
Previous Names: N/A
1514 Jefferson Highway
New Orleans, LA 70121

Primary Contact

Nicole Swan
Two doctors reviewing chart

Organizational Information

ACO Participants

ACO Participant
ACO Participant in Joint Venture
Acadiana Family Physicians, Inc., APMC
N
Christopher D. Naquin, MD, APMC
N
Contemporary Women’s Care of Breaux Bridge
N
Damon T. Cudihy, MD LLC
N
Daniel Services, LLC
N
David Ashton Reed, MD, Internal Medicine LLC
N
John M. Wise, MD
N
Elizabeth B. White, MD, Inc.
N
Family Practice Associates of Shreveport
N
IMC-Diagnostic and Medical Clinic, LLC
N
IMC-Eastern Shore Adult Medicine, LLC
N
IMC-Eastern Shore Family Practice, LLC
N
IMC-Family Medical of Mobile, LLC
N
Internal Medicine Clinic of Morgan City, LLC
N
James M. Robinson, MD, LLC
N
Jeanne D. Theriot, MD, APM, LLC
N
Jennings American Legion Hospital, Inc.
N
Kenner Physician Associates, LLC
N
Lafayette Health Ventures, Inc.
N
Louisiana Intern Medicine and Pediatric Associates, LLC
N
LSU Health Sciences Center-Shreveport Faculty Group Practice
N
MP Medical Partners, LLC
N
Ochsner Bayou, LLC
N
Ochsner Clinic, LLC
N
Ochsner Mississippi, LLC
N
Ochsner University Hospital & Clinics
N
Physician Practice Partners
N
Prevention Plus Clinic, LLC
N
Robin Dale, MD, LLC
N
Rowe S. Crowder III, MD, PLLC
N
Singing River Gulfport
N
Singing River Health System
N
Slidell Memorial Hospital
N
St. Tammany Emergency Physicians Group, LLC
N
St. Tammany Parish Hospital Service District No. 1
N
Titus County Hospital District
N
Total Anesthesia Care, STPH, LLC
N
Trahan Consulting Group, LLC
N
Westbank Medical Associates
N

ACO Governing Body

Member First Name
Member Last Name
Member Title/Position
Member’s Voting Power (Expressed as a percentage)
Membership Type
ACO Participant Legal Business Name, if applicable
Robert
Hart, MD
Chairman
4.16%
Yes, ACO Participant Rep
Ochsner Health
Sandy
Badinger
Slidell Memorial Hospital, CEO
4.16%
Yes
Slidell Memorial Hospital
Michael
Carey, MD
Medicare Beneficiary
4.16%
Medicare Beneficiary Representative  
Wayne
Cestia, MD
Ochsner Lafayette General, Physician
4.16%
Yes
Ochsner Lafayette General  
Joan
Coffman
St. Tammany Health, CEO
4.16%
Yes
St. Tammany Health
Corwin
Harper
Ochsner LSU Health System, CEO
4.16%
Yes
Ochsner LSU Health System
Charles
Fox III, MD
Ochsner LSU Health System, Physician
4.16%
Yes
Ochsner LSU Health System
Chaillie
Daniel
Shreveport Family Medicine, Physician
4.16%
Yes
The Daniel Clinic
Eric
Gallagher
Ochsner Health Network, CEO
4.16%
No, Non-ACO Participant Rep
Ochsner Health Network
Patrick
Gandy
Ochsner Lafayette General, CEO
4.16%
Yes
Ochsner Lafayette General
Michael
Hulefeld
Ochsner Health, COO
4.16%
No
Ochsner Health
Louis
Jeansonne, IV, MD
Ochsner Health, Physician
4.16%
Yes
Ochsner Health
Amanda
Logue, MD
Ochsner Lafayette General, Physician
4.16%
Yes
Ochsner Lafayette General  
Matthew
McElveen, MD
Slidell Memorial Hospital, Physician
4.16%
Yes
Slidell Memorial Hospital
Nicole
McKee, MD
Terrebonne General Health, Physician
4.16%
Yes
Terrebonne General Health
Peter
November
Ochsner Health, CEO
4.16%
Yes
Ochsner Health  
Phyllis
Peoples
Terrebonne General Health, CEO
4.16%
Yes
Terrebonne General Health
Jim
Malloy
Ochsner Health, CFO
4.16%
No
Ochsner Health
Sidney “Beau”
Raymond, MD
Ochsner Health Network, CMO
4.16%
No
Ochsner Health Network
Timothy
Riddell, MD
Ochsner Health, Physician
4.16%
Yes
Ochsner Health
Aldo
Russo, MD
Ochsner Health, Physician
4.16%
Yes
Ochsner Health
Patrick
Torcson, MD
St. Tammany Health, Physician
4.16%
Yes
St. Tammany Health
Scott
Fenn
Infirmary Health, CEO Designee
4.16%
Yes
Infirmary Health
Jacob
Webster, MD
Infirmary Health, Physician
4.16%
Yes
Infirmary Health

Key ACO Clinical and Administrative Leadership

Name
Title
Sidney “Beau” Raymond, MD, MMM FACP
Ochsner Accountable Care Network Executive Director, Medical Director, Ex-Officio Ochsner Accountable Care Network Board Member
Eden Ezell
Compliance Officer
Marcela Chanes
Quality Assurance/Improvement Officer

Associated Committees and Committee Leadership

Committee Name
Committee Leader Name and Position
Network Development Committee
Philip Oravetz, MD, Chief Population Health Officer, Ochsner Health Network

Thomas Groves, Vice President, Network Development, Ochsner Health Network
Performance and Operations Committee
Sidney “Beau” Raymond, MD, MMM, FACP, Ochsner Accountable Care Network Executive Director, Medical Director, Ex-Officio Ochsner Accountable Care Network Board Member

Eric Gallagher, Chief Executive Officer, Ochsner Health Network

Types of ACO Participants, or Combinations of Participants, That Formed the ACO

  • ACO professionals in a group practice arrangement
  • Hospitals employing ACO professionals
  • Networks of individual practices of ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses:

  • Third Agreement Period
    • Performance Year 2022, $21,137,348
    • Performance Year 2021, $17,601,341
    • Performance Year 2020, $22,355.579
    • Performance Year 2019, $13,262,736

Shared Savings Distribution:

  • Third Agreement Period
    • Performance Year 2022
      • Proportion invested in infrastructure: 25%
      • Proportion invested in redesigned care processes/resources: 25%
      • Proportion of distribution to ACO participants: 50%
    • Performance Year 2021
      • Proportion invested in infrastructure: 25%  
      • Proportion invested in redesigned care processes/resources: 25%
      • Proportion of distribution to ACO participants: 50%
    • Performance Year 2020
      • Proportion invested in infrastructure: 7%
      • Proportion invested in redesigned care processes/resources: 18%
      • Proportion of distribution to ACO participants: 74%
    • Performance Year 2019
      • Proportion invested in infrastructure: 7%
      • Proportion invested in redesigned care processes/resources: 18%
      • Proportion of distribution to ACO participants: 74%

Quality Performance Results

2021 Quality Performance Results

Quality performance results are based on CMS Web Interface Measure Set.
Measure #
Measure Name
Collection Type
Rate
ACO Mean
CAHPS-1
Getting Timely Care, Appointments, and Information
CAHPS for MIPS Survey
86.59
83.96
CAHPS-2
How Well Providers Communicate
CAHPS for MIPS Survey
94.66
93.47
CAHPS-3
Patient’s Rating of Provider
CAHPS for MIPS Survey
93.36
92.06
CAHPS-4
Access to Specialists
CAHPS for MIPS Survey
79.74
77.00
CAHPS-5
Health Promotion and Education
CAHPS for MIPS Survey
62.94
62.68
CAHPS-6
Shared Decision Making
CAHPS for MIPS Survey
62.01
60.97
CAHPS-7
Health Status and Functional Status
CAHPS for MIPS Survey
71.48
73.06
CAHPS-9
Courteous and Helpful Office Staff
CAHPS for MIPS Survey
95.00
91.97
CAHPS-11
Stewardship of Patient Resources
CAHPS for MIPS Survey
28.3
25.62
Measure 479
Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups  
Administrative Claims
0.16
0.15
Measure 484
Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions  
Administrative Claims
28.28
30.97
Quality ID 318
Falls: Screening for Future Fall Risk  
CMS Web Interface
97.67
87.83
Quality ID 110
Preventative Care and Screening: Influenza Immunization
CMS Web Interface
81.39
77.34
Quality ID 226
Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention
CMS Web Interface
94.44
79.27
Quality ID 134
Preventative Care and Screening: Screening for Depression and Follow-up Plan
CMS Web Interface
92.58
76.97
Quality ID 113
Colorectal Cancer Screening
CMS Web Interface
86.85
75.32
Quality ID 112
Breast Cancer Screening
CMS Web Interface
88.67
78.07
Quality ID 438
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
CMS Web Interface
87.81
86.37
Quality ID 370
Depression Remission at Twelve Months
CMS Web Interface
0.00
16.03
Quality ID 001
Diabetes: Hemoglobin A1c (HbA1c) Poor Control
CMS Web Interface
8.83
10.71
Quality ID 236
Controlling High Blood Pressure
CMS Web Interface
83.47
76.16
For Previous Years’ Financial and Quality Performance Results, please visit data.cms.gov.

Payment Rule Waivers

  • Skilled Nursing Facility (SNF) 3-day Rule Waiver:
    • Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR §425.612.
  • Waiver for Payment for Telehealth Services:
    • Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR §425.612(f) and 42 CFR §425.613.

Other Services

Outpatient Case Management

Ochsner Accountable Care Network will provide outpatient case management for a limited period of time to beneficiaries who are considered high risk for healthcare complications as determined by an appropriate algorithm. This effort will achieve triple aim results through enhanced care coordination with the goal of reducing the incidence of healthcare complications.

Care Coordination

In order to achieve better health for individuals, better health for populations, and lowered growth in expenditures, Ochsner Accountable Care Network provides various interventions, including home visits, visits in the community, and phone conversations as an in-kind service.

Partial Backstopping of Shared Losses

Ochsner Accountable Care Network will financially assess all participant community practitioners a portion of shared losses incurred at the ACO level. This will be calculated based upon beneficiary attribution and not to exceed a set amount per practitioner. All participants will therefore be responsible for some level of downside financial risk in order to create accountability for their attributed population of beneficiaries. It is necessary to limit the exposure to downside financial risk for community participants so that potential penalty does not preclude them from participation. This also allows Ochsner Accountable Care Network to reach wider geographic and socioeconomic spread of beneficiaries. This effort will achieve triple aim results by creating a shared incentive to improve care coordination.

Electronic Health Record System

Ochsner Accountable Care Network will provide a subsidy and/or discount to participant community practitioners to join into a single, unified Epic EHR platform. Participant community practitioners that can adequately interface with Epic will have the option to retain their own EHR system, and all other participants will be required to use the Epic EHR. Ochsner Accountable Care Network will also give participants the option to lease the necessary hardware needed to operate the Epic EHR at a discounted rate to eliminate the barrier for adoption. This effort will achieve triple aim results through improved EHR communication and care coordination.

Digital Medicine Program(s)

Ochsner Accountable Care Network has a primary goal of advancing the Triple Aim for the Medicare beneficiaries attributed through the Shared Savings Program. In order to achieve better health for individuals, better health for populations, and lowered growth in expenditures, Ochsner Accountable Care Network will enter beneficiaries suffering from certain chronic conditions and diseases into our digital monitoring program(s). To help them manage these conditions and diseases, we will provide items to promote beneficiaries’ adherence to their care plans and proactively identify changes in their health. This effort will achieve triple aim results through enhanced care coordination with the goal of reducing the incidence of chronic disease.

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